Hebbard G S, Samsom M, Sun W M, Dent J, Horowitz M
Department of Medicine, Royal Adelaide Hospital, Australia.
Am J Physiol. 1996 Nov;271(5 Pt 1):G814-9. doi: 10.1152/ajpgi.1996.271.5.G814.
Hyperglycemia slows gastric emptying in normal individuals and patients with diabetes mellitus and may affect both somatic and visceral sensation. The effects of hyperglycemia on proximal gastric motility and sensation during intraduodenal infusion of a triglyceride emulsion were evaluated using a barostat in six normal subjects during euglycemia and hyperglycemia (approximately 15 mmol/l). Isobaric distension induced greater bag volumes during hyperglycemia compared with euglycemia at 3 (452 +/- 26 vs. 343 +/- 12 ml, P < 0.05) and 4 mmHg (600 +/- 55 vs. 497 +/- 50 ml, P < 0.05) above basal pressure. During isovolumetric distension, intrabag pressure was less during hyperglycemia at 500 (2.5 +/- 0.3 vs. 3.5 +/- 0.5 mmHg above basal pressure, P < 0.05) and 600 ml (3.0 +/- 0.4 vs. 4.5 +/- 0.5 mmHg above basal pressure, P < 0.05). Perception of nausea (P < 0.05) and fullness (P < 0.05) was increased during hyperglycemia compared with euglycemia. We conclude that hyperglycemia 1) reduces proximal gastric tone during intraduodenal triglyceride infusion, an effect that may contribute to delayed gastric emptying, and 2) increases the intensity of nausea and fullness during intraduodenal triglyceride infusion and proximal gastric distension, indicative of an effect on visceral sensation.
高血糖会减缓正常人和糖尿病患者的胃排空,并可能影响躯体和内脏感觉。在十二指肠内输注甘油三酯乳剂期间,使用恒压器对6名正常受试者在血糖正常和高血糖(约15 mmol/l)状态下高血糖对近端胃动力和感觉的影响进行了评估。与血糖正常时相比,在高于基础压力3 mmHg(452±26 vs. 343±12 ml,P<0.05)和4 mmHg(600±55 vs. 497±50 ml,P<0.05)时,高血糖状态下等压扩张诱导的袋容量更大。在等容扩张期间,在500 ml(高于基础压力2.5±0.3 vs. 3.5±0.5 mmHg,P<0.05)和600 ml(高于基础压力3.0±0.4 vs. 4.5±0.5 mmHg,P<0.05)时,高血糖状态下袋内压力更低。与血糖正常时相比,高血糖期间恶心(P<0.05)和饱腹感(P<0.05)的感知增加。我们得出结论,高血糖:1)在十二指肠内输注甘油三酯期间降低近端胃张力,这一作用可能导致胃排空延迟;2)在十二指肠内输注甘油三酯和近端胃扩张期间增加恶心和饱腹感的强度,表明对内脏感觉有影响。